ABSTRACT
Background:"I fear the man who has practised one kick 10,000 times." Lee Bruce This aphorism highlights the growing importance of simulation in postgraduate urology training, especially during the COVID 19 pandemic, when all teaching and training activities were stopped, jeopardising postgraduate residents' education. Postgraduate residents must perform hours of surgical training to overcome urological learning curves. According to study, residents educated on simulators boost their summative scores. By introducing simulation to urology training in a way comparable to the well-known Halsted apprenticeship model, the current study emphasises the hybrid model of IKD. Objective(s): to compare the formative assessment results between residents taught on simulators and residents in the conventional apprenticeship model on factors of communication skills, technical competence, and overall capacity to conduct procedure on OSAT and DOPS. Material(s) and Method(s): from 2019 to 2021 this comparative study was conducted in the Department of Urology by Team C at the Institute of Kidney Diseases Peshawar. Group A (10 residents) and Group B (10 residents, 5 from the second and third years) received STEPS method OT instruction in the first phase. These simulators were used to impart knowledge to Group "B" Harvey for counseling and medical examinations Simulator for PCNL The second phase included a six-month training assignment swap between the two groups. A standard QSAT and DOPS proforma was used to evaluate each resident. Data analysis was done using SPSS 24.0. Result(s): Residents in Group A, who were originally exposed to the conventional technique, considerably outperformed Group B on Harvey (mean: 50.5;standard deviation: 2.21.1) in terms of communication skills, professionalism, and ethical concern during the first phase (p 0.001). However, the Group p0.05 shown considerably higher technical proficiency and overall process performance capacity. The mean technical skill and overall capacity to finish the process had a somewhat positive association in phase 1 in favour of group B (r=0.630, p 0.01). All QSAT and DOPS metrics significantly improved in the second phase. However, both groups did not vary significantly (p> 0.05). According to Pearson coefficient correlation, both groups considerably overcame their gaps in technical proficiency, communication skills, and procedural competence. (P= 0.001) Results are shown in Figures 1 through 06 and Tables 1 through 2. Conclusion(s): To improve the standard of urology residency in Pakistan, a hybrid paradigm that includes both simulation and actual performance is necessary. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
ABSTRACT
The worldwide spread of the coronavirus disease 2019 (COVID-19) pandemic and the significant morbidity and mortality rate associated with it led to the rapid development of several COVID-19 vaccines. While serious side effects related to the vaccines are rare, various adverse events have been reported to occur after COVID-19 messenger RNA (mRNA) vaccination, including myocarditis, Guillain-Barré syndrome, and thrombosis. Postural orthostatic tachycardia syndrome (POTS) is a chronic cardiovascular dysautonomia among young and middle-aged individuals. Although the pathophysiology of POTS is thought to be heterogeneous, vaccine-induced immune-mediated autonomic dysfunction is hypothesized to be one cause of the syndrome. In this report, we present a case of myocarditis and POTS occurring in a 13-year-old male following COVID-19 mRNA vaccination. He presented with persistent severe fatigue and headache. The patient's symptoms improved after intravenous immunoglobulin for myocarditis, non-pharmacologic interventions, and multiple medications for POTS.
ABSTRACT
Introduction: COVID-19 has negatively impacted on all aspects of surgical training, compounding longstanding issues with surgical trainees achieving required endoscopy training standards. Innovative approaches are required to ensure trainees progress appropriately. Aim(s): We aim to present an ideal immersive training pathway for endoscopy training for General Surgery trainees. Result(s): JAG certification has strict criteria which are achievable during a six month "immersive" training period with six, half day, sessions per week. JAG basic skills courses should be booked in advance and ideally complete in The 2nd to 3rd month of training. Weeks 1-2: Supervised simulator training to introduce basic scope handling and manipulation. Observation of "upper" and "lower" lists to grasp understanding of patient journey. Weeks 3-4: Attend at lEast 3 dedicated training sessions per week with DopS discussion and completion. ongoing simulator practice (1-2 sessions per week). Attendance at service lists with recognised trainers (1-2 sessions per week);likely to be opportunities for trainees to participate on ad Hoc basis. Weeks 4-20: As per weeks 3-4 with an increased attendance of ad Hoc lists and reduction of simulation to one session per week. Weeks 20-24: Consolidation of learning, endoscopies undertaken with minimal assistance from trainer. Weeks 24-26: Reduced capacity lists with trainer in The Department but out-with scope room in preparation of independent lists after JAG certification. Conclusion(s): We have described The ideal immersive endoscopy training pathway. Consideration should be given to incorporating this into The General surgical curriculum around on-call commitments, elective operating and clinics.